US military veterans living in areas with a history of economic discrimination face an increased risk of death, according to a study that adds to the evidence of social factors’ impact on health.
(Bloomberg) — US military veterans living in areas with a history of economic discrimination face an increased risk of death, according to a study that adds to the evidence of social factors’ impact on health.
Research published Tuesday in the JAMA medical journal looked at neighborhoods that were redlined nearly a century ago — designated as less fit for investment by banks and mortgages because of high minority populations and low incomes. From early 2016 to the end of 2019, veterans with heart disease who lived in these areas were still 13% more likely to die than those in districts that hadn’t been designated this way.
Long since halted, redlining is now known as a discriminatory practice that began in the US in the 1930s and systematically denied services and investments to minority neighborhoods. Even decades later, residents of areas with lower investment grades during the redlining era continue to suffer from elevated health risk compared to their peers in districts with higher ratings.
“We still have work to do to try to make things more equitable for everyone, especially with regards to health care,” said Salil Deo, a heart surgeon at the Louis Stokes Cleveland VA Medical Center. Deo led the study along with Sadeer Al-Kindi, a preventive cardiologist at University Hospitals in Cleveland.
Under the post-World War I New Deal, the Home Owners’ Loan Corp. created a color-coded grading system to classify neighborhoods based on their perceived loan risk. The ratings led to decades of disinvestment and economic disparities in neighborhoods with predominantly Black or immigrant populations, the researchers said. Health suffered too: Redlined neighborhoods were disproportionately exposed to environmental health hazards and lacked access to care, according to the study.
The researchers examined the medical records of nearly 80,000 veterans for four years in a variety of neighborhoods across the US. Those with existing heart disease who lived in formerly redlined districts were 15% more likely to experience a heart attack during the study period.
Neighborhood characteristics should be a consideration in heart disease risk assessments, the researchers said. Other studies have shown that lack of access to recreational land space and healthy foods can combine with other environmental exposures to increase stress and harm health. Addressing these factors, along with restricting tobacco availability and improving health-care delivery models could improve heart health in formerly redlined neighborhoods, they concluded.
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